What Is Syphilis?
Syphilis is a sexually transmitted infection caused by a
type of bacteria known as Treponema pallidum. According to the Centers
for Disease Control and Prevention (CDC), in 2013, more than 56,400 cases
of syphilis were reported in the United States. According to the Mayo
Clinic, the rate of women infected with syphilis has been declining in the
United States, but the rate among men, particularly homosexual men, has been
The first sign of syphilis is a small, painless sore. It can
appear on your sexual organs, rectum, or inside your mouth. This sore is called
a chancre. People often
fail to notice it right away.
Syphilis can be challenging to diagnose. You can be infected
without showing any symptoms for years. However, the earlier you discover the
infection, the better. Syphilis that remains untreated for a long time can
cause major damage to important organs, like the heart and brain.
Syphilis is only spread through direct contact with
syphilitic chancres. It can’t be transmitted by sharing a toilet with another
person, wearing another person’s clothing, or using another person’s eating
Stages of Syphilis Infection
The four stages of syphilis are:
Syphilis is most infectious in the first two stages.
When syphilis is in the hidden, or latent, stage, the
disease remains active but often with no symptoms and is not contagious to
others. Tertiary syphilis is the most destructive to your health.
The primary stage of syphilis occurs about three to four
weeks after you’re infected with the bacteria. It begins with a small, round
sore called a chancre. A chancre is painless, but it’s highly infectious. This
sore may appear wherever the bacteria entered your body, such as on or inside
your mouth, genitals, or rectum.
On average, the sore shows up around three weeks after
infection, but it can take between 10 and 90 days to appear. The sore remains
for anywhere between two to six weeks.
Syphilis is transmitted by direct contact with a sore. This
usually occurs during sexual activity, including oral sex.
During the second stage of syphilis, you may experience skin
rashes and a sore throat. The rash won’t itch and is usually found on your
palms and soles, but it may occur anywhere on the body. Some people don’t
notice the rash before it goes away.
Other symptoms of secondary syphilis may include:
- swollen lymph glands
- weight loss
- hair loss
- aching joints
These symptoms will go away whether or not you receive
treatment. However, without treatment you’ll still be infected.
Secondary syphilis is often mistaken for another condition.
The third stage of syphilis is the latent or hidden stage.
The primary and secondary symptoms disappear, and you won’t have any noticeable
symptoms at this stage. However, you will still be infected with syphilis. The
secondary symptoms can reappear, or you could remain in this stage for years
before progressing to tertiary syphilis.
The last stage of infection is tertiary syphilis. Approximately
to 30 percent of people who don’t receive treatment for syphilis will enter
this stage. Tertiary syphilis can occur years or decades after you’re initially
infected. Tertiary syphilis can be life-threatening. Some other potential
outcomes of tertiary syphilis include:
- mental illness
- memory loss
- destruction of soft tissue and bone
- neurological disorders, such as stroke or
- heart disease
- neurosyphilis, which is an infection of the brain
or spinal cord
How Is Syphilis Diagnosed?
If you think you might have syphilis, go to your doctor as
soon as possible. The doctor will take a blood or urine sample to run tests,
and they’ll also conduct a thorough physical examination. If a sore is present,
your doctor will take a sample from the sore to determine if the syphilis
bacteria are present.
If a doctor suspects that you’re having nervous system
problems because of tertiary syphilis, you may need a spinal tap, or lumbar
puncture. During this procedure, your spinal fluid is collected so that your
doctor can test for bacteria.
If you’re pregnant, the doctor might screen you for syphilis
because the bacteria can be in your body without you knowing it. This is to
prevent the fetus from being infected with congenital syphilis. Congenital
syphilis can cause severe damage in a newborn. It can even be fatal.
Treating and Curing Syphilis
Primary and secondary syphilis are easy to treat with a
penicillin injection. Penicillin is one of the most widely used antibiotics and
is usually effective in treating syphilis. People who are allergic to
penicillin will likely be treated with a different oral antibiotic, such as doxycycline,
azithromycin, or ceftriaxone.
If you have neurosyphilis, you’ll get daily doses of
penicillin intravenously. This will often require a brief hospital stay. Unfortunately,
the damage caused by late syphilis can’t be reversed. The bacteria can be
killed, but treatment will most likely focus on easing pain and discomfort.
During your treatment, make sure to avoid sexual contact
until all sores on your body are healed and your doctor tells you it’s safe to
resume sex. If you’re sexually active, your partner should be treated as well.
You shouldn’t resume sexual activity until both of your treatments are
How to Prevent Syphilis
The best way to prevent syphilis is to practice safe sex.
Using condoms during any type of sexual contact is a good idea. In addition, it
may be helpful to:
- avoid having sex with multiple partners
- use a dental dam (a square piece of latex) or
condoms during oral sex
- avoid sharing sex toys
- get screened for sexually transmitted infections
and talk to your partners about their results
Syphilis can also be transmitted through shared needles.
Avoid sharing needles if you’re going to use drugs.
Complications Associated with Syphilis
Pregnant Mothers and Newborns
Mothers infected with syphilis are at risk for miscarriages,
still births, or premature births. There’s also a risk that an infected mother
will pass the disease on to her fetus. This is known as congenital syphilis.
Congenital syphilis can be life-threatening. Babies born
with congenital syphilis can also have the following:
- developmental delays
- swollen liver or spleen
- infectious sores
If a baby has congenital syphilis and it isn’t detected, the
baby can develop late-stage syphilis. This can lead to damage to their:
People with syphilis have a significantly increased chance
of getting HIV. The sores the disease causes make it easier for HIV to enter
It’s also important to note that those with HIV may
experience different syphilis symptoms than those who don’t have HIV. If you
have HIV, talk to your doctor about how to recognize syphilis symptoms.
When Should I Test for Syphilis?
The first stage of syphilis can easily go undetected, and
the symptoms in the second stage are also common symptoms of other illnesses.
This means that if any of the following applies to you, you should probably be
tested for syphilis. It doesn’t matter if you’ve ever had any symptoms. Get
tested if you:
- have had unprotected sex with someone who might
have had syphilis
- are pregnant
- are a sex worker
- have exchanged sex for drugs
- are in prison
- have had unprotected sex with multiple people
- have a partner who has had unprotected sex with
- are a man who has sex with men
If your test comes back positive, it’s important to complete
your full treatment. Make sure to finish your full course of antibiotics, even
if your symptoms disappear. You should also avoid all sexual activity until
your doctor tells you that it’s safe. You might also consider being tested for
People who have tested positive for syphilis should notify
all of their recent sexual partners so that they can also get tested and